Childhood trauma and psychiatric comorbidities in patients with depressive disorder in primary care in Chile

J Trauma Dissociation. 2017 Mar-Apr;18(2):189-205. doi: 10.1080/15299732.2016.1212449. Epub 2016 Oct 26.

Abstract

Childhood trauma is associated with different psychiatric disorders during adulthood. These disorders are often presented in comorbidity with depression.

Objective: To establish the relationship between psychiatric comorbidities and childhood traumatic events in patients with depression in Chile.

Methods: Three hundred and ninety-four patients with major depression were assessed using the MINI International Neuropsychiatric Interview and a screening for childhood trauma.

Results: Social anxiety disorder was associated with having witnessed domestic violence during childhood (OR = 2.2, CI 1.2 - 3.8), childhood physical abuse (OR = 2.7, CI 1.6 - 4.4), physical injury associated with physical abuse (OR = 2.3, CI 1.3 - 4.7) and sexual abuse by a non-relative (OR = 2.7, CI 1.3 - 4.2). Posttraumatic stress disorder was associated with physical injury associated with physical abuse (OR = 1.9, CI 1.1 - 3.6), sexual abuse by a relative (OR = 3.2, IC 1.8 - 5.9) and sexual abuse by a non-relative (OR = 2.2, CI 1.2 - 4.1). Antisocial personality disorder was associated with traumatic separation from a caregiver (OR = 3.2, CI 1.2 - 8.5), alcohol abuse by a family member (OR = 3.1, CI 1.1 - 8.1), physical abuse (OR = 2.8, CI 1.1 - 6.9) and sexual abuse by a non-relative (OR = 4.8, CI 1.2 - 11.5). Panic disorder was associated with sexual abuse by a relative (OR = 1.9, CI 1.1 - 3.1). Generalized anxiety disorder was associated with sexual abuse by a non-relative (OR = 1.9, CI 1.1- 3.3).

Conclusions: Further clinical recognition is required in patients seeking help for depression in primary care. This recognition must take into account the patient's current psychiatric comorbidities and adverse childhood experiences.

Keywords: Major depression; childhood trauma; psychiatric comorbidities.

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology
  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Chile / epidemiology
  • Comorbidity
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology*
  • Domestic Violence / psychology
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • Panic Disorder / epidemiology
  • Panic Disorder / psychology
  • Primary Health Care*
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology